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RC-14-658ami Shores Vill ilding Departril .E.2nd Avenue, Miami Shores, Flom 4: (305) 795.2204 Fax: (305) 756.85 TION'S PHONE NUMBER: (305) BUILDING PERMIT APPLICATION 03 2 Permit No. M2 ( Master Permit No. Permit Type: BUILDING ROOFING JOB ADDRESS: City: Miami Shores County: Miami Dade Zip:&� Folio/Parcel#: Is the Building Historically Designated: Yes NO Flood Zone: OWNER: Name (Fee Simple Titleholder):0b1^k5 )Qh't` t Cft$ (1iy CIA�C- Phone#: 9 09M Address:r City: CO 'a �$� )+ Ali �°'� StateT� Zip33 y�8 Tenant/Lessee Name: Phone#: Email: V10-%. OAC4CI(cc'4e, A) nn-v,n.1. 61 CONTRACTOR: Company Name: D SAM ar C *4 S f, -LG f) �4 yfaW Phone#: W(0— Address: -31 ca Al. t,,,/ of 7 T*, X City: 5,zA /'% i t State: L Zip: 1 V75 1 Qualifier Name: Phone#: l g(' — Z -ttq State Certification or Registration #: f C.& 16 1 qS 3 Certificate of Competency #: Contact Phone#: Email Address: DESIGNER: Architect/Engineer: Phone#: Value of Work for this Permit: dw Square/Linear Footage of Work: 10049 5!1 >1' Type of Work: ❑Addition XAlteration ❑New ❑Repair/Replace ❑Demolition Description of Work: R 6lDzatloy, C/!' Ad a-cLee '84Ahly&ft 0., a,& 1 a f u ce Color thru tile: Submittal Fee Scanning Fee $ Permit Fee $_ Radon Fee $ Notary $ Training/Education Fee $ Double Fee $ Structural Review $ CCF CO/CC $ DBPR $ Bond $. Technology Fee $ TOTAL FEE NOW DUE $ V l Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence uch posted notice, the inspection will not beAWroved and a reinspection fee will be charged. /j Signature Signature ._• a Owner or Aeent Contractor The foregoing instrument was acknowledged before me this day of t , 201, by111 n'���( Jam• who is p go lly kn„ ow i to me or who has produced _ As identificaam- nd who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: -91004 APPROVED BY MONICA RWIERA My COMMISSION # EE 022431 EXPIPGc• ne,.,..,,—.,.. 8wtded' The foregoing instrument was acknowledged 6efor'e me this day of ` % , 20% , by ec�i,�/,;g, e!2�6H who is p sonally known to me or ho has produced IffiTcation and who did take an oath. NOTARY PUBLIC: Structural Review (Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) Clerk zip zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRICAL WORK, PLUMBING, SIGNS, WELLS, POOLS, FURNACES, BOILERS, HEATERS, TANKS and AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence uch posted notice, the inspection will not beAWroved and a reinspection fee will be charged. /j Signature Signature ._• a Owner or Aeent Contractor The foregoing instrument was acknowledged before me this day of t , 201, by111 n'���( Jam• who is p go lly kn„ ow i to me or who has produced _ As identificaam- nd who did take an oath. NOTARY PUBLIC: Sign: Print: My Commission Expires: -91004 APPROVED BY MONICA RWIERA My COMMISSION # EE 022431 EXPIPGc• ne,.,..,,—.,.. 8wtded' The foregoing instrument was acknowledged 6efor'e me this day of ` % , 20% , by ec�i,�/,;g, e!2�6H who is p sonally known to me or ho has produced IffiTcation and who did take an oath. NOTARY PUBLIC: Structural Review (Revised 5/2/2012)(Revised 3/12/2012) )(Revised 06/10/2009)(Revised 3/15/09)(Revised 7/10/2007) Clerk ki u April 30, 2014 Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, Florida 33138 Responses to Building Comments Permit Number: RC -4-14-658 Address: 1165 NE 91 st Terrace Buildina Critique: 'y 1/.Sheet AC -1 has been revised by the mechanical engineer to show the R -values of roof e,, and wall insulation; Sheet A-1 has been clarified by hand by the Architect of Record; ✓" 3. Sheet A-2 has been clarified by hand by the Architect of Record; . 4. (2) new crawl space vents have been added to sheet A-2, see new note 33 Sincerely, Victor J. Bruce A.I.A., LEED R AP Vice President & Architect AR -0017103 A&I associates, inc. 70 NE 101" Street Miami Shores, Florida 33138 telephone 305-310-5030 fax 1-877-408-8280 email vbruceCr t.ii cassodcifes f,e? Miami Shores Village 7 uilding Department SVA (NSPECTION 50 N.E.2nd Avenue, Miami Shores, Florida 33138 Tel: (305) 795-2204 Fax: (305) 756-8972 LINE PHONE NUMBER: (305) 762-4949 BUILDING PERMIT APPLICATION E!(BUILDING ❑ ELECTRIC ❑ ROOFING i JUL 14 2014 w� FBC 20 Master Permit No. '�(- — (�5—K Sub Permit No. ❑ REVISION ❑ EXTENSION [:]RENEWAL ❑ PLUMBING ❑ MECHANICAL ❑ PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP CONTRACTOR DRAWINGS JOB ADDRESS: Tei+,. City: Miami Shores County: Miami Dade Zip: 3'? 138_ Folio/Parcel#: Is the Building Historically Designated: Yes NO >(I Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE: OWNER: Name (Fee Simple Titleholder): C11",' � / yk t7 -e r V-< Phone#: Address: 11 (,e S N• C CO T-er . City:�qStater Zip: Tenant/Lessee Name: Phone#: Email: CONTRACTOR: Company Name: 60�/Uc4rA C/ Gv IE Phone#: Address: (g(j N, („/ Of 7 t t,, City: 5(44&:k State: ISL_ Zip: )S/ Qualifier Name: (( d ."i:5 -Q A Phone#: (/ �Sr State Certification or Registration #: r G G i 5 ( C15 -3 ( Certificate of Competency #: DESIGNER: Architect/Engineer: Phone#: Address: City: State: Zip: Value of Work for this Permit: $ Square/Linear Footage of Work: Type of Work: ❑ Addition Alteration ❑ New ❑ Repair/Replace ❑ Demolition Description of Work: R t /'/v r{l/ o�►�/ $ Specify color of color thru tile: Submittal Fee $ Scanning Fee $ _ Technology Fee $_ Structural Reviews (Revised02/24/2014) Permit Fee $ CCF $_ Radon Fee $ DBPR $ Training/Education Fee $ 'O/Cr $' Notary $ Double Fee $ Bond $ TOTAL FEE NOW DUE $ Bonding Company's Name (if applicable) Bonding Company's Address City State Mortgage Lender's Name (if applicable) Mortgage Lender's Address City State Zip Zip Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS, FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC..... OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws regulating construction and zoning. "WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING YOUR NOTICE OF COMMENCEMENT." Notice to Applicant: As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the inspection will not be appro a reinspection fee will be charged. S Signature Signature gnature OWNER or AGENT CONTRACTOR The fore oing instrumentw ack owledged before m this The foregoing instrum t was acknowledged before me this day of 20 , by day of 20 by i who is personally known to who is personally known to ma,or _why has produced as me or who has produced identification and who did take an oath. identification and who did take an oath. NOT Sign Prirr Seal ****a A (Revised02/24/2014) Certificate of Completion Miami Shores Village 10050 NE 2 Ave, Miami Shores FI, 33138 Tel: 305-795-2204 Fax: 305-756-8972 Building Inspection Department This certificate issued pursuant to the requirements of the Florida Building Code 106.1.2 certifying that at the time of issuance this structure was in compliance with the various ordinances of the jurisdiction regulating building construction or use. For the following: Permit Type RESIDENTIAL CONSTRUCTION Bldg. Permit No. RC -4-14-658 Owner CHRISTOPHER CARVER Contractor DENMAR CONSTRUCTION GROUP Subdivision/Project NONE Date Issued 03/13/2015 Occupancy Construction Type V -B Load 4 Square Footage 1000 Ocpceupancy Ty SINGLE FAMILIY Description of RELOCATE MASTER BATH AND Applicable Work INTERIOR RENOVATION Code 2010 FLORIDA BUILDING Location 1165 NE 91 TER Miami Shores FL 33138 Flood Zone AE F.F.E 6.50 J,31151,1 Building Officials A.. Ismael Naranjo, Not Transferable POST IN A CONSPICUOUS PLACE Inspection Worksheet Miami Shores Village 10050 N.E. 2nd Avenue Miami Shores, FL Phone: (305)795-2204 Fax: (305)756-8972 Inspection Number: INSP-229659 Permit Number: RC -4-14-658 Scheduled Inspection Date: March 11, 2015 Permit Type: Residential Construction Inspector: Rodriguez, Jorge Owner: CARVER, CHRISTOPHER AND Job Address: 1165 NE 91 Terrace Miami Shores, FL 33138 - Project: <NONE> Contractor: DENMAR CONSTRUCTION GROUP comments Inspection Type: Final Building Work Classification: Alteration Phone Number Parcel Number 1132050010180 RELOCATION OF MASTER BATHROOM & INTERIOR ------ REFINISHING. _____REFINISHING. INSPECTOR COMMENTS False Phone: (954)372-6623 March 10, 2015 For Inspections please call: (305)762-4949 Page 19 of 29 Inspector Comments Passed Failed Correction Needed Re -Inspection ❑ Fee No Additional Inspections can be scheduled until re -inspection fee is paid. March 10, 2015 For Inspections please call: (305)762-4949 Page 19 of 29 ip, i JX T T INPPCTION, ,. ZONING I. . INSPE4 1 N IDAT Foundation i'Z Final Sternwall N M Slab W r ice Columns 1`st Lift Columns 2nd Lift T taut , J 1 Tie Beam its Truss/Rafters Tank ;. Roof SheathingSewer -UR Bucks oof ins Windows/Doots Gas Interior Ftami D i . L at►k. Insulation .+?' rale Well t CeilingGrid O ei ra i.Wrl' D air Firewall P�SoI. ndin ' it Wire Lath Pool Wet Niche!( . . Pool Steel Lind . rd ; 706 -946 -Ml P.1 Broward Insulation. Inc 954-486-5993 P.1 BUILDING PERMfT*. INSULATION INSTALLATION CERTIFICATE Prwany Address. ctli-S4aZB ZP Lelial Desci"=.TCwrstrip Range -secfim S-ubdhftkn 8-fockffilwW Lot The undersigniad hereby CWNW 111101: KmAntion has been m--da-W in the above-describW reciukenaft for R - Val afthefts FnsrWFffx%enLyCode, asfdjoW Property W Most the mfr vin 1- Exterior CBS welts have been insiulaw with (Cheat one from VM ID a 0 Spray an Cellulose thidmess of hCha&, which thickness, acccremj 0 C Fjx� eatti Rock Wool Batts to 1 )W- AluminLim Foil 0 polyur pane Vdl Vidd an 'W Value Of M -bags per square feet 0 0 Poq Oche- Exterior (Frame VW19) haw been wouldedw9h (Check one from the column at 0 Spray on Cellulose right) to a thidmess of Inches. which thickness, according 0 0 Fibergl Rock ass Batts Wool Batts to E3 Numinurn Foii 0 Polyurethane will "V yield an 'R' value of - 0 Other 2 Callings (level" have been insulated with (Cheat one ftrr, the column to the Fiberglass 8 lednicals fight) tDathickness of J_,;_kichesmftchthickness according 0 Fiberglass Loose Fill Rock Wool Blankets to � . I t f. , vA-J yveld an'fr value 0 Rock WWI Loose Fill 0 Cellulose Locr-10 FM Of0 at bags W thousand sqjam beet Other coning (valtedcathedral) hwm - kisubted with (Check am from the E3 0 Mass OLankeft Fiberglass Lome FBI C011.11frin t13 the 0911111 to 3 2111CIM988 of inchm vh*M Vilckriess. 0 Rock Wool Blankaft _ 8=01(b to viN yield an'fr value 0 0 Rock Wool Loose Fill Cellulose Lome Fill El Oftr Of 3 fritaiiar Khaa Walls have been iramdafAd vvilh a Mineral Fjbw Batt to a thicknow of vrmhm which thfckneaa` accordhM to MA"UFAMItER -vwMVtddan'Frvakwaf 4- G=P P8rbWn Waft OfWnftoned RWQ area have tim which thidMe". nocom" to %VAWFAC`nXEP --- %vrl ylefdan *fr varve of 5. The following areas twoe not been kwgatect Br. Date. 0 -UMM LOCI ,t --, .),�/7 1 MOM PAULPIE M 9JMUY NM&fy Pok - State Of Flof id a My Comm. Expires Oct 2, 2017 Commission # FF 05=11 Mission: Rick Scott To protect, promote & improve the health Governor of all people in Florida through integrated state, county & community efforts. FicinaaJohn H. Armstrong, MD, FACS HCJI! LTH State Surgeon General & Secretary Vision: To be the Healthiest State in the Nation February 26, 2014 Denmar Construction Group 3180 NW 97 Way Fort Lauderdale, FL 33351 RE: Modification to a Single Family Residence - No Bedroom Addition Application Document Number: AP1131322 Centrax Permit Number: 13 -SC -1514037 1165 NE 91 Terrace Miami, FL 33138 Lot: 20 Block: 1 Subdivision: Dear Applicant, This will acknowledge receipt of a floor plan and site plan on 01/07/2014 for the use of the existing onsite sewage treatment and disposal system located on the above referenced property. Interior remodelation with same # of bedrooms. No objection letter was issued by C. icaza on 02126114. This office has reviewed and verified the floor plan and site plan you submitted, for the proposed remodeling addition or modification to your single-family home. Based on the information you provided, the Health Department concludes that the proposed remodeling addition or modification is not adding a bedroom and that it does not appear to cover any part of the existing system or encroach on the required setback or unobstructed area. No existing system inspection or evaluation and assessment, or modification, replacement, or upgrade authorization is required. Because an inspection or evaluation of the existing septic system was not conducted, the Department cannot attest to the existing system's current condition, size, or adequacy to serve the proposed use. You may request a voluntary inspection and assessment of your system from a licensed septic tank contractor or plumber, or a person certified under section 381.0101, Florida Statutes. If you have any questions, please call our office at (305) 623-3500. Sincer , i (i Carl aza Engine r III Department of Health in Dade County Florida Department of Health www.FloridasHenith.com in Dade County - • , Florida TWITTER:HeafthyFLA PHONE: (305) 623-3500 FACEBOOK:FtDepartmentofHealth YOUTUBE: ftdoh March 5, 2015 Miami Shores Village Building Department 10050 NE 2nd Avenue Miami Shores, Florida 33138 Final Inwection Leer Permit Number: RC -4-14-658 Address: 1165 NE 91 st Terrace Building Department, I, Victor I Bruce and Architect of Record, having performed visual observations of the project and performed and approved the required masonry inspection at the renovation, hereby attest to the best of my knowledge, belief, and professional judgment, the structural and envelope components of the above referenced renovation are in compliance with the approved plans. I also attest that to the best of my knowledge, belief, and professional judgment, the approved permit plans represent the as built condition of the structural envelope component of the said structure. Please contact me at 305.310.5030 if you have any questions and/or comments erely, Victor J. Bruce A.I.A., Architect AR -0017103 370 NE i0V'Street Miami Shores, Florida 33138 teiephone 305-310-5030 fax 1-877-408-8280 email vbruce4-ai-associates.nei U.S. DEPARTMENT OF HOMELAND SECURITY FEDERAL EMERGENCY MAAAGEMEN7AGENCY ELEVATION CERTIFICATE NaOMS N0, 1660-00081660-0008tional Flood lnsu>~ance Program itl Portant: RiAd the illStru coons on pages -;9, - Explr�IDTi i9ate:.luiyr 31, 2015 -- SECTION A - PROPERTY INFORMATIONF+ci131NsiiR,6,niCE t;l30MPA1!Y USE Al. Buiidi Owner's Nam CHR TOPHER TU 14-678 Palicyl~lurri#jer A2. Building Street Address (including P,pf , Nu Unit, Suite, and/or Bldg. No.) or P.O. Route and Box No. Company NAjD mber, 1165 N.E. 91 TERRACE - MIAMI SHORES FLORD4A 3i13Crde A3- PrnnarFvflacrrinff „n m - .__._, . o . , o..�, �,uu�uciI 1-ayai ucsuupuun, eu:.l E35 OF LOT 20 & W401___0_ T -O'T 1 'T nr+v i v "D n ,-, A,.,? 1 L I- " H4. ounoing use e.g., Residential, Non -Residential, Addition, Accessory, etc.) RESIDENTIAL A5. Latitudell-ongiiude:.Let. N25°51' 35.681ong, W80° 10' 25.85" Horizontal Datum: 0 NAD 1927 NAD 1983 A6. Attach at least 2 photographs of the building if the Certificate is being used to obtain flood insurance. AT Building Diagram Number 8 . ` A8: For a building with a crawlspace or enclosur s A9. For a building with an attached garage: a) Square footage of crawlspace or enclosure(S) 2 , 293 sq ft a) Square footage of attached garage N/A sq ft b) Number of permanent flood openings in the crawlspace or enclosures)12 b) Number of permanent flood openings in the ched garage within 1.0 foot above adjacent grade within 1.0 Toot above adjacent grade N / c) Tatal�iet area of flood openings in AB.b �,2 sq tri c) Total net area of flood openings in A9.b N7A- sin d) Engineered flood openings? q Yes .No d) Engineered flood openings? 0 Yes No SECTION B - FLOOD INSURANCE RATE MAP (FIRM) INFORMATION B1. NFIP Community dame & Community Number B2. County dame B3. State VILLAGE OF MIAMI SHORES 1206 ? 'MTAUT_n An 84. Map/Panel Number B5. Suffix B6. FIRM index Date B7. FiRM Panel B8. Flood 89. Bad Floodlelevation(s) (Zone 12086CO306 L 9/11/09 Effective/RevisedDate Zone(s) AO, use base flood depth) 9/11/09 AE 8.00' 810- indicate tAe snurrp of tha Roee r� �_.:_� _ _ - F1S Profile FIRM' Q CommunityDetermined. Other/Source: Bl 1. Indicate elevation datum used for BFE in Item B9: 0 NGVD,182s, a NAVD 1988 ) Other/Source- B12. Is the building located in a Coastal Barrier Resources System (CBRS) area or Otherwise Protected Area (OPA)? Designation Date: N/A 0 Yes No a CBRS OPA ' SECTION C- BUILDING ELEVATION INFORMATION (SURVEY REQUIRED) Ci.- Building elevations are based on; Construction Drawings' 0 Building Under Construction" ( Finished Construction *Anew Elevation Certificate will be required when construction of the building is complete. C2. Elevations - Zones Al A30, AE, AH, A (with BFE), VE, V1 V30, V (with BFE), AR, ARIA, ARAE, AR/A1 A30, AR/AH, AR/AO. Complete Items C2.e-h below according to the building diagram specified in item A7. In Puerto Rico only, enter meters. Benchmark Utilized: B-62 Vertical Datum: AiO![3 9929 Indicate eievation datum used forthe elevations in items a) through h) below. 0 N13VD 11329. %7.-NAi/D1988 0 other/So=6: Datum used for building elevations must be the. same as that used for the BFE. - Check the measurement used. a) Top of bottom* floor (including basement, craWISP ace, or enclosure floor) 6 .50 21 feet meters b) Top of the next higher floor 8 .O1 0 feet 0,meters c) Bottom of the lowest horizontal structural member (V Zones only) N A .2] feet #7 meters d) Attached garage (top of slab) N/A . feet meters ,)�j e) Lowest elevation of machinery or equipment servicing the building 6 .35 feet [3 meters (Describe type of equipment and location in Comments) 1) Lowest adjacent (finished) grade next to building (LAG) 6.05 feet meters g) Highest adjacent (finished) grade next -to building (HAG) :::i:.T0— 0 feet EJ meters h) Lowest adjacent grade at lowest elevation of deck or stairs, including structural support N/A . N feet 0 rn iers SECTION D - SURVEYOR, ENGINEER, OR ARCHITECT CERTIFICATION This certifiication is to be signed and sealed by a land surveyor, engineer, or architect authorized by law to certify elevation information. 1 certify that the information on this Certificate represents my best efforts to interpretthe data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 9001. 0 Check here if comments are provided on back of form. Were latitude and longitude in Section A,provided by a 8b-1 9.114 Check here if attachments. licensed land surveyor? Yes t3 No P f �24 Certifier's Name Adis N. unez License Number 5924 Title Reg- Land Sury6ybr Company Name Blanco Surveyors, Inc. Address 555 N re Dr.City Miami Beach State FL ZIP Code 33141 Signature Date 8 / 19 / 14 Telephone 305-865-1200 JQN Utlli;I IFICATEpaga 2 IMPORTANT: in these spaces, copy the corresponding information from Section A. ; Building Street Address ((indI �q FOR Wsuk cE COMPANY, ME 1165 N ..E .. 9 I TERRAL�' Unit, Suite, and/or Bldg. No.) or P:O: Route and Bex No: City. PollyN>Jrnbrrr� MIAMI Si30RES State ZIP Cd FLORIDe , 4 FLORIDA'.- 3313ti fAlWanY"CXumber SECTION D-. SURVEYOR.. ENGINEER, OR ARCHITECT CERTIFICATION (CQNT1Ni1ER} Copy both sides of this Elevation Certificate for (1) communityofficia1 (2) insurance agenticompany, and (3) building owner. Comments LATITUDE &LONGITUDE OBTAINED BY GOOGLE:' CROWN OF 'T E ROAD ELEVATION: -5.751.,_)N CENZERLINE ON:;CENTER OF. I{OAD., BM#- B-6 -.:,. ...:.1,OGATOR. 3250 5.:-- ELEV: 8.6-7' Signature : ; Date Lz 8J.1.9/14 SECTION E -BUILDING ELEVATION INFORMATION (SURVEY NOT REQUIRED) FOR ZONE AO AND ZONE A T For Zone AO and A (without BFE), complete Items E1 E5. If the Certificate is intended to support a LOMA of LOMR-F request, coni late s HO BFE) and -C.* For Items E1 E4, use natural grade, rf available.. Check the measurement used. In Puerto Rico.onty, enterzne#ars P actions A, B, E1. Provide elevation information for ttie fotfowing and check the`apprflpriaie bsaxes to show whetfiier the elevabon.Is.above.or. below the highest ad'acent grade,(HAG) and the lowest adjacent grade:(LAG)•-; > - 1 11, a) TOP. - op of botiorn floor (including basement crawlspace; or enclosure) is b) Top of bottom floor (including basement, crawlspace, oz.enclosure) Is f meters above or eat [ below the 1-14G E2. For Building Diagrams 6-g yuith pe>manentfloo. d openings provided.in`Sechon A items B a pe(s{�ages 8 9. obi 1 strucfionsihe next hi hsr floor ove oro belowtheLAG. (elevation C2.b in the diagrams) of the building is E3. Attached garage (top of slab) is Q feet'. LI meters j� above or..13 below the: HAG. E2 feet Q meters 0 above or `j= j below the iiAG. E4 Top of platfoml of.machinery and/or equipment seniicin the buildin is .E5 Zone AO only If no flood de g g feet 13 meters =j above or Q below the 1dE+,G. depth number is available, is the top of the bottom floor elevated in accordance wrin the community s floodplain management arrlinance7_''�J Yes Q No llnkriawn. T#te iocai of ictal must cetttiy this information in Section G. SECTION F -PROPERTY OWNER (OR OWNER'S .REPRESENTATIVE) CERTIFICATION The property owner or owner's authorized representative who completes Sections A B, and E for Zone A (wifliout a FEMA Issued or community issued BFE) or Zone AO must sign here. The statements to Sections A, B; and E are correct to the`bes# a# my. knowledge: Property P nY Owner's or Owner's Authorized Representative's Name Address Sime ZIP Code Signature ._.... - . Date Telephone Comments Check here if. attachments. SECTION O COMMUNITY INFORMATION (OPTIONAL) . -he local official who is authorized by taw or ordinance to administer the community's floodplain management ordinance can complete Sections A, B C (or and G I this Elevation Certificate. Complete the applicable items) and sign below. Check the measurement used in Items .G8 -G10. In Pueiio.Rico only, enter meters.. 31. Q The jnfoization'ia Section C was taken from other documentation that bas'bean signed and sealed by a licensed sui*ro.r, engineer, or architect who is authorized by law to certify elevation lrrfor-oration (Indicate the source and date of the elevation data in the Comments area below.) '2• A community official completed Section E for a ding located in Zone A (without a FEMAassued or.communiiy-issued $FE) or Zone A0. . 33- The following information (Items Gel -G10 u ) is provided for community floodplain management Purposes.: G4. Permit Number G5. Date Permit issued G6. Date Certificate Of Compliance/Occupancy, Issued. 7. This petrriit has been issued for. 0 New Construction Q: Substantial Improvement 8. Elevation of as -built lowest floor (including basement) of the building: 9. BFE or {in Zone AO) depth of flooding atthe b»ilding site: i feet- - j I feet meters Datum Q meters Datum 10. Community's design flood elevation - fl feet } meters Datum -ocalOfficial's Name Title . Iommunity Name Telephone Signature Date :omments D Check here if attachments.